Active NPI
Austin Beavers, QBHP
- Case Manager/Care Coordinator
- Mountain Home, AR
National Provider Identifier
1245603497
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 707 N Cardinal Dr
Mountain Home, AR 72653-3253 - Phone
- (870) 425-5644
- NPI assigned
- Nov 10, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
707 N Cardinal Dr
Mountain Home, AR 72653-3253
Mailing address
205 High School Dr
Salem, AR 72576-9556
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 227364795 | Medicaid | AR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593648000000",
"number": "1245603497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 HIGH SCHOOL DR",
"city": "SALEM",
"state": "AR",
"postal_code": "725769556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 N CARDINAL DR",
"city": "MOUNTAIN HOME",
"state": "AR",
"postal_code": "726533253",
"telephone_number": "870-425-5644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAVERS",
"first_name": "AUSTIN",
"credential": "QBHP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-11-10",
"last_updated": "2020-07-02",
"certification_date": "2020-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "227364795",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mountain Home, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.